hocks and stifles, and injections

Backyarder
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hocks and stifles, and injections

Postby Backyarder » Mon Jul 22, 2019 3:02 pm

So, I have posted in the seniors forum about this a bit but it was suggested that I post here. I'm not sure anything is to be done about it..it's been and being done ...but I'd love to hear about your experiences and maybe there are some suggestions out there.In my head I think I know the outcome...


I have a 17 year old Morgan mare, I bought her as a 15 year old...she'd been basically a pasture puff , ridden casually as a trail horse and lesson horse occassionally ..after having had 5 foals.
I started schooling and riding her 5 days a week and over the two years we've done well...till this spring....she came out of a long winter with only turnout and no riding looking good and I started her slowly..a bit of lunging and light riding...a montrh into it I started noticing that she looked off on th lunge and then started feeling it under saddle in trot. She always warmed out of it and we kept going....but then it really started to worry me...so I had the vet do a lameness exam, fexion tests and xrays of both hocks and hind fetlocks. The xrays showed advanced arthritis in the right hock and some in the left, fetlocks looked ok..but the vet was convinced she could see something there when she was trotted out.
So... off to the clinic for injections, both hocks and the questionable fetlock. Soe stall rest, a week off with only quiet turnout...and then a restart.. no change...and in a month she seemed worse...at one month the vet had said the injections should be at thier peak, doing thier job....nada

I sent videos to my vet and she suggested I bring her in again so I did, this time they did fexion tests, blocked fetlocks, hocks...and it appeared to be a stifle problem...they xrayed the rt stifle and sure enough it shows a significant lesion and so vague changes on another aspect of the joint...likely early arthritis...
The stifle was injected and I brought her home.
again, stall rest, turnout only for a week and a half...then start up...walking in hand for 10-15 minutes for a few days , a walk under saddle for 30 minutes ,then I walked and trotted her on the lunge...I did not lunge her...just enough to get a video for the vet....she seemed much worse than before the injections in my eyes....the vet agreed....no swelling, no heat...so Bute x2 for 3 days and then x1/day for two weeks to take care of any inflammation that might be there...she said to continue to riding at a walk and to use poles for strenghtening and then reaccess...

I'm a bit discouraged , this is very likely my last horse, I already have a retiree...a third riding horse is out of the question....

anyone with suggestions for exercises...anything?

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Chisamba
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Re: hocks and stifles, and injections

Postby Chisamba » Mon Jul 22, 2019 5:49 pm

A significant lesion where in her stifle?

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Re: hocks and stifles, and injections

Postby Backyarder » Mon Jul 22, 2019 7:59 pm

yes, lesion on the end of the femor
Last edited by Backyarder on Fri Aug 02, 2019 7:44 pm, edited 2 times in total.

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Re: hocks and stifles, and injections

Postby blob » Mon Jul 22, 2019 8:10 pm

I don't have specific experience with arthritic changes in the hocks and lesions in the stifle like you're describing. But I wanted to share this exercise that is mostly used for SI injury rehab, but could also be useful for the stifle:

Space 3-4 poles out for the walk (4' apart). Walk the horse (under saddle or in hand) diagonally across the poles. Make a generous, wide and come the other way, so that you're creating a hourglass type figure with diagonal lines across the poles.

This exercise is relatively low impact since it's at the walk, but it makes the horse lift their hind leg higher and bring it under and across.

The other thing is that the more and more I spend time among horses and horse people the more convinced I am that stall rest can often do more damage than good. i am not a vet, so my experiences are truly anecdotal. But I've seen more than one horse develop arthritis after extended stall rest for an injury. And I've seen 'dr green' do a lot of good often for complicated situations. Talk to your vet and others, but perhaps giving your horse some let down time in pasture might bring her back to more comfortable place physically.

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musical comedy
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Re: hocks and stifles, and injections

Postby musical comedy » Mon Jul 22, 2019 10:34 pm

Terminology is important here. When I hear 'lesion' I do not think of arthritis. I'm wondering if she has what my horse has, which is a subcronodral bone cyst. See the damage 'hole' in the cartilage.
https://images.app.goo.gl/Snvvd4zxspDjiydu7

When something like this is close to the joint, then it rubs and causes pain.

Or, in your horse's case, could a lesion mean some damage to the meniscal ligaments. In that case, rest is needed; not injections.

I'm one of those owners that gets very involved in the vet findings and has copies of my xrays. I want to know exactly what the findings are so that I can research them myself. Sadly I do this because sometimes vets are wrong and give out contraindicated advice.

In any case, for arthritis, I would have expected the injection to have helped a lot for at least a brief time. That it didn't, and that the horse looks worse, might mean he has something else going on. It doesn't sound like they blocked the stifle, but just assumed if it wasn't hocks, it was stifle. I know some vets do not want to block the stifle because it is very painful for the horse and you can't sedate because you need to see the horse trot afterwards.

A horse can have hocks issues, stifle issues, AND other things. Perhaps look at an S/I problem.

The sad fact is that some horses break down and don't stay servicably sound.

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Re: hocks and stifles, and injections

Postby Sue B » Mon Jul 22, 2019 10:56 pm

Perhaps get a second opinion?

Stall rest is not beneficial for arthritis, walking is. I think you do not really know yet where the pain is coming from and I agree with MC that looking at the si joint would be a good idea.

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Re: hocks and stifles, and injections

Postby Backyarder » Tue Jul 23, 2019 1:15 am

The stall rest I mentioned was only for 24 hours after the hocks and fetlock were injected...and for 24 hours after the stifle was injected...no long standing time...she's been moving ...out about 18-19 hours a day, in for feed and when it's too hot to be out.
Musical Comedy ...her Xray looks very much like the cyst in the link. Terminology should be " cystic lesion".
I'm sure that a 17 year old horse would likely show some wear and tear in most joints if they were xrayed. I'm going to follow Dr's orders and give it a while longer , some mild exercise , anti-inflammatories and see how she does.
I have her on Cosequin and started her on hemp meal. I have faith in my vet.

Blob , I will try that exercise.

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musical comedy
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Re: hocks and stifles, and injections

Postby musical comedy » Tue Jul 23, 2019 9:09 am

Backyarder wrote:Musical Comedy ...her Xray looks very much like the cyst in the link. Terminology should be " cystic lesion".
Hmm. Did you get xrays on her when you bought her or do you have any baseline xrays?

I had owned my horse for a long time before we found the cyst. It was a fluke how we found it. I was getting some xrays done for some reason, and the vet slides the camera to the medial stifle. I say "I didn't ask for stifle xrays". He said "it's on the house". Well, low and behold we find the cyst. My vet is an advanced event rider and he had recently vetted a horse for himself and found a cyst on the PPE. So, he just wondered if that might be the reason my guy was always a positive on right hind flexions.

As time past, my guy started to show gimping on that right hind, and now we knew what it was. We injected with steroids twice and there was no improvement. We tried Irap, and it worked!! But, it took a while.

The first Irap injections were (as I recall) weekly. A series of I think 5-7 injections. Then followed by a booster every 2-3 months. I continued this Irap maintenance for going on 4 years now. (I'd have to check exact date). He's retired now, due to heart problems, not soundness. He's still looks super sounds on limbs!

This last time we switched from Irap to Prostride. It's cheaper and we don't have to do as many injections.

The last time xrays were done, they showed the lesion had started to repair itself. He was one of the Irap success stories. Not all horses respond this way.

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Re: hocks and stifles, and injections

Postby khall » Fri Jul 26, 2019 2:52 am

I had IRAP done on my older mare in 2016. She has bi lateral OCD lesions with the left being the worst. She had been sound and working for several years and then she foundered on dex June 2015, spent 10 months in the stall came out very lame LH. Could not use any treatment that included steroids, so IRAP was the only choice at the time. She had 3-4 injections and is still sound now though not in work but not because of unsoundness.

I had done the typical injections as a much younger horse and they just would not hold. So took her out of work for several years until I found Conquer. Once I put her on Conquer she was so much better and good work helped keep her going well. She is not on any joint maintenance at this time, if I put her back in work then I probably will put her on oral HA.

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Re: hocks and stifles, and injections

Postby Backyarder » Tue Aug 13, 2019 12:38 am

Lottie has become worse under saddle, seems pasture sound...she's fine to walk around the ring but trotting is painful....so I'll take her for a walk now and then and let her enjoy her life.
I discussed other treatments and the vet feels that nothing will help ...we can't make the lesion go away...it is what it is.

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Re: hocks and stifles, and injections

Postby Srhorselady » Tue Aug 13, 2019 3:52 pm

I’m so sorry. That is hard. I’ve had several senior horses I was able to ride into their late 20s and early 30s. BUT my neighbor has a mare I take care of (neighbor is in her 90s and mostly housebound). She got the mare at 16 and she was a former cutting and team penner. Well two years later she was diagnosed/x-rayed with cartilage issues in stifle and (at that time) nothing could be done. She has been a pasture puff ever since. Neighbors horse so I didn’t get diagnosis details. She’s now in her mid/late 20s with what looks like stifle issues in the other rear as well, probably compensatory. She is mostly three legged lame but gets around quite well. Not what you wanted to hear I’m sure, as a rider, but her quality of life is reasonable.

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Re: hocks and stifles, and injections

Postby Backyarder » Tue Aug 20, 2019 12:15 pm

SRhorselady, I also have had several older horses that were ridden late into thier twenties...it's very disappointing that this little gem won't be. SO far I am still riding her at a walk doing some trail obstacles and working on my position and just keeping us both going a bit. She'll retire here and have a quiet life with my senior mare who is now 26. Seems like I'm starting a collection of retirees...I board a 12 year old that is unsafe to ride, so is also retired.

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Re: hocks and stifles, and injections

Postby Srhorselady » Wed Aug 21, 2019 12:08 am

WOW! You have had it bad. I DO understand. I’ve lost three senior horses in the last two years and have three more over 20. One is rideable walk only (nerved due to navicular), the second can do a little more but goes off if worked very long. He has either a tendon or coffin bone ligament issue (MRI required to tell for sure) from an old injury now compounded by arthritis. Vet says we have done what can be done so he is in light trail riding. The third is my 21 year old pony. She is sound but I am recovering from two surgeries this summer so we will see what fall brings as far as riding goes. Horses! There is always something. However, my vet strongly believes in keeping them moving if at all possible so that is what we will do. Good luck with yours.


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